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neuromanagement > 10 July: Vestibular > Flashcards

10 July: Vestibular Flashcards

1
Q

vestibulo - ocular

A

keeps image steady of fovea during head movements

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2
Q

vergence

A

to keep image on fovea predominately when the viewed objects is moved near

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3
Q

BPPV is apart of what dysfunciton system

A

PERIPHERAL

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4
Q

how do you diagnose BPPV?

A

Dix Hallpike Maneuver

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5
Q

how do you treat BPPV?

A

Epley’s Manuever

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6
Q

cranial nerves for vision:

A

optic
oculomotor
trochelar
abducens

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7
Q

cranial nerves for the vestibular

A

facial and vestibulocochlear

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8
Q

cranial nerves for swallowing / sucking

A

glossopharyngeal

vagus

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9
Q

cranial nerves for tongue movement

A

hypoglossal

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10
Q

cranial nerve for chewing / facial expression

A

facial n

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11
Q

spontaneous nystagmus means that there is a

A

CENTRAL VESTIBULAR PROCESSING PROBLEM

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12
Q

fixed gaze nystagmus means that

A

nystagmus occurs while they move thier eyes

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13
Q

occulomotor range of motion is looking to see if

A

the eyes move together smoothly

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14
Q

convergence is the ability to

A

converge on an that comes into your midline - less than 6 cm away you should start seeing double: X on brock string

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15
Q

what do you do to help convergence?

A

a Brock String

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16
Q

cover-uncover test tests for?

A

Tropia

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17
Q

how do you test for tropia?

A

a cover uncover test

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18
Q

alernate cover test tests for

A

phoria

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19
Q

how do you test for phoria?

A

alternate cover test?

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20
Q

tropia is when

A

the eye Adducts to focus once you cover the eye and then deviates when uncovered

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21
Q

phoria is when

A

you cover the eye THAT eye ABducts and then return once you regain fixation on target

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22
Q

how do you test VOR?

A

tilt pts head down 30 degree
start slowly moving head side to side start increasing speed? or do the thing in lab where he jilted the head = HEAD THRUST TEST

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23
Q

spontaneous nystagmus present

A

acute UVL, brainstem/cerebellum abnormality

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24
Q

Decreased VOR (+ Head Thrust Test)

A

Acute UVL and chronic vestibular hypofunction

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25
Q

eye movements and vertigo elicited by maneuvers

A

vestibular asymmetry BPPV

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26
Q

impaired VOR smooth pursuits saccades

A

central deficits brain stem/ cerebellar abnormality

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27
Q

imbalance while standing or walking

A

any of the above

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28
Q

what are compensatory techniques?

A

increase response of remaining vestibular system

CNS changes to optimize functional cortical remapping / neuroplasticity

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29
Q

goal of compensation:

A

improve and equalize normal gaze and postural control

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30
Q

adaptation:

A

brain will adapt to input received and either tune out information it determines to be an error or activate another system to correct the mismatch

31
Q

substitution

A

strengthen the function of intact systems to improve performance

32
Q

habituation

A

repeatedly expose the individual to provoking stimuli so they no longer respond as strongly to it

33
Q

substitution of other strategies to replace the lost or impaired function include:

A

eye tracking
oculomotor exercises
saccades

34
Q

cheap dynavision is part of what method of increasing function?

A

SUBSTITION

35
Q

the funky looking picutres with ALOT of stimulus was what method ?

A

HABITUATION

36
Q

the looking at the finger while moving was what mehtod?

A

ADPATATION

37
Q

name three convergence exercises?

A

pencil push ups
brock string
arrow chart / dot card

38
Q

how many times should you do vestibular therapy in each setting?

A

outpatient : 1-2 times /week (4-6 weeks)
HEP : 5 minutes 3x / day
walking program ( health and fitness prescription)

39
Q

VOR means

A

Vestibular Ocular Reflex

40
Q

VOR works on

A

stabilizes vision when head moves

41
Q

VSR means

A

vestibular spinal reflex

42
Q

VSR works on

A

balance control

43
Q

ampulla can detect what

A

linear/ angular motion

44
Q

otolith organs hold what

A

the crystals that detect movement and determine gravity and acceleration

45
Q

VCR stands for

A

Vestibular Collic Reflex

46
Q

VCR works on

A

stabilizes the head in space

47
Q

how does VCR work?

A
  1. detects rotation
  2. inhibits and excites the extra ocular muscles on the other side
  3. creates compensating eye movement
48
Q

the ratio of eye to head movement should be

A

1.1 abnormal ratios can cause symptoms of blurry vision or vertigo

49
Q

the vestibular system has three output SYSTEMS:

A

peripheral senosry apparatus
central processing
mechanism for motor output

50
Q

the peripheral sensory apparatus handles three things?

A

vestibular
vision
somatosensory / proprioception

51
Q

which Vest System invovles the apparatus in the inner ear? (semiciruclar canals utricle saccule CN VII: )

A

PERIPHERAL

52
Q

which vestibular systems has stuff to do with the brainstem and cerebellum?

A

CENTRAL

53
Q

why is the vascular supply important

A

the vertebral-basilar a system is the main supplier to both central and peripheral vestibular system

54
Q

vestibular neuritis:

A

vestibular crisis = vertigo imbalance nausea

- absence of associated auditory symptoms

55
Q

viral endolymphatic labryinthitis

A

acute vestibular crisis lasting 1-4 days

- HEARING LOSS w/n a few hours before or after onset of vertigo

56
Q

so main difference between vestibular neuritis and viral endolymphatic labryinthiits?

A

HEARING LOSS

57
Q

acoustic neuroma

A

nerve sheath benign tumors arise from Scwann cells lining the axons of the cochleovestibular n.
causes progressive unilateral hearing loss or tinnitus w/ o vestiubular s/s

58
Q

meniere’s disease:

A

disorder of the inner ear fx resulting in devastating hearing loss and vestibular symptoms

59
Q

BPPV definition:

A

extereme vertigo triggered by lying down and other positions

60
Q

BPPV is caused by

A

crystals in otilith to be “knocked out” and caused problems with acceleration and gravity

61
Q

BPPV stands for :

A

benign paroxygmal positional vertigo

62
Q

what are the two theories of BPPV?

A

canalithiasis

cupulolithiasis

63
Q

canalithiasis is what?

A

debris floating freely in the endolymph in the long arm of the semi circular canal SCC

64
Q

cuplolithiasis

A

debris, probably fragment of otconia from the utricle adhere to the cupula

65
Q

which theory is the most excepted in the BPPV?

A

canalithiasis theory

66
Q

how do you treat the canalithiasis theory of BPPV?

A

repositioning maneuver / procedure EPLEY

67
Q

TORSION nystagmus suggests:

A

BPPV POSTERIOR!

68
Q

persistent torsion nystagmus means that

A

cupulolithiasais

69
Q

transient torsion nystagmus means that

A

its canalithiasis

70
Q

what is the most common single bilateral vestibulopathy

A

gentamicin toxicity

71
Q

how is gentamicin toxicity confirmed? tested?

A

rotary chair test

72
Q

a migraine w/o aura is

A

periodic s/s of normal headaches throbbing worse with activity and associated w/ nausea and increased sensitivity to light and noise

73
Q

a migraine w/ aura is

A

short lived symptoms : noises flashes of light tingling numbness vertigo and others known as the aura
- s/s usually precede the headache and usually last 5-20 mins

74
Q

a basilar migraine

A

include vertigo tinnitus, decreased hearing and ataxia

neuromanagement (10 decks)

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